The aim of this project is to both improve and expand the imaging capabilities of the Axiom lab C-arm CT system by upgrading to the Siemens Artis zeego, a robot-mounted digital flat panel C-arm. The equipment will be shared by 15 users. A total of 13 NIH grants (R01s, R21s, K99, SCRR, P50, STTR) and several unfunded projects will be significantly enhanced by the instrumentation purchase. The hardware technology that will greatly enhance our imaging capabilities is the Siemens Artis zeego system, currently the only system of its kind being sold. The three main technical advantages of this system are: 1. 6-degrees-of-freedom robot-mounted C-arm, for full flexibility of trajectory specification;2. very high frame rate digital detector (120 fps);3. Very fast, very reproducible rotations and/or motions for pre-defined trajectories (up to 1200/s). This system provides the opportunity to do real-time fluoroscopic imaging during motion, weight-bearing high-resolution CT imaging, ECG- gated cardiac imaging, and quantitative perfusion over a volume that is large enough to cover the whole human brain. The system sits squarely in an x-ray imaging regime that is not currently covered by any other technology, and therefore provides a unique opportunity to investigate new questions and develop new imaging protocols. We are moving from treating a disease based on average response to treating the disease based on the individual patient's specific characteristics. Imaging and Image Guidance have key roles to play, with the potential to provide targeted, personalized healthcare by combining high-resolution diagnostic imaging, intra-procedural guidance, and evaluation of response to a given therapy. Research and development of imaging protocols and image guidance techniques on the zeego system will be directly translatable into the clinic, and so the system also provides an important bridge from bench to bedside. PUBLIC HEALTH RELEVANCE: The overall goal of this project is to upgrade the Axiom lab to a Siemens Artis zeego robot-mounted digital flat panel C-arm fluoroscopy and CT imaging system. The system will be used for research in a broad range of areas including weight-bearing high-resolution CT imaging, quantitative perfusion imaging and cardiovascular imaging. The system provides an important bridging diagnostic and image guidance technology that will help move new therapies into the clinic.